| Background:5-aminolevulinic Acid-Photodynamic therapy(ALA-PDT)has been extensively studied and found to be with significant curative effect or special value for condyloma acuminatum,moderate and severe acne,precancerous lesions,and skin cancer.However,in the course of treatment,patients may experience pain and other discomforts,leading to decreased compliance and affecting the efficacy of ALA-PDT.Therefore,it is necessary to observe the characteristics of adverse reactions and take countermeasures.Objective:To observe the adverse reactions of ALA-PDT in the treatment of moderate and severe acne,precancerous lesions of skin cancer,skin tumors and condyloma acuminatum,and to observe and analyze the effect of two-step irradiance schedule during ALA-PDT on the treatment of condyloma acuminatum.Methods:1)An ambispective cohort study was conducted among patients who received ALA-PDT treatment in the Department of Dermatology from June 2018 to January 2021,and they were divided into moderate and severe acne group,skin precancerous lesions and skin tumors group,and routine condyloma acuminatum group.All subjects received a questionnaire and a physical examination before and after treatment.The contents of the questionnaire mainly included the subjects’ demographic characteristics,Visual analogue scale(VAS)and adverse reactions after treatment.Dermatological physical examination performs a dermatological examination of a subject for the investigator(dermatologist)to determine changes in skin lesions.SPSS software was used for statistical analysis of the data.2)Patients with condyloma acuminatum from June 2018 to January 2021 were divided into two groups according to the order of treatment,that is,patients admitted from June 2018 to October 2020 were treated with conventional ALA-PDT;Patients admitted from November 2020 to January 2021 were in the two-step group of condyloma acuminatum,who received ALA-PDT two-step irradiance schedule during ALA-PDT.A non-randomized controlled trial was conducted to compare the adverse reactions(pain severity and duration)between the two groups,as well as the difference in efficacy between the two approaches.Subjects in both groups received the above questionnaire and physical examination before and after treatment.SPSS software was used for statistical analysis of the data.Results:1)A total of 55 patients,including 31 males and 24 females,aged 17-90 years,were included,including 16 patients in the moderate and severe acne group,14 patients with precancerous lesions or skin cancer group,16 patients in the conventional treatment group of condyloma acuminatum,and 9 patients in the two-step treatment group of condyloma acuminatum.Patients in the moderate and severe acne group had longer pain duration after the first and third treatment(3.9±1.8 days and 3.3±1.4 days,respectively)(P<0.05).Patients in the conventional radiation group had the longest pain duration after the second treatment(3.9±2.0 days,P<0.05).The total score of pain VAS in the first three groups was 7.5± 1.3 in the second treatment,which was higher than the total score of 7.0±1.8 in the first treatment,indicating that the severity of pain in the second treatment was higher than that in the first treatment.Within 1 week of the first treatment,the patients with moderate and severe acne had the most severe pain(VAS assessment 6.4±1.9 points);within 1 week of the second treatment,the patients with moderate and severe acne had the most severe pain(VAS assessment 6.8±1.1 points);and within 1 week of the third treatment,the patients with condyloma acuminatum had the most severe pain(VAS assessment 5.8±1.8 points).2)Comparison between the two groups of patients with condyloma acuminatum,conventional group in the first ALA-PDT VAS pain score 7.1 ±2.0,when the pain lasts days 3.4±1.7 days after treatment,the two-step group in the first ALA-PDT VAS pain score 5.3±2.0,1.5± 1.4 days of constant pain(p<0.05),the above results show that the two-step method can alleviate pain severity,shorten the duration of the pain.There was no statistical significance in the total effective rate and recurrence rate between the two-step irradiance schedule group and the conventional group(P>0.05).Conclusion:During the first ALA-PDT,the highest pain degree and longest pain duration occur in the moderate and severe acne group,while the lowest pain degree and the shortest pain duration was in the precancerous lesions and skin cancer group.During the second ALA-PDT,the pain VAS evaluation in all patients was higher than that in the first treatment.The highest pain degree was in the moderate and severe acne group,and the pain duration was the longest in patients with condyloma acuminatum.During the third time of ALA-PDT,condyloma acuminatum group had the highest pain degree,and the pain duration in moderate and severe acne group was the longest.ALA-PDT two-step irradiance schedule for condyloma acuminatum can effectively reduce the degree of pain,and shorten the duration of pain,on the cure rate of condyloma acuminatum has no significant effect,so ALA-PDT two-step method for condyloma acuminatum has good clinical promotion value. |
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